mippo微创入路和后外侧入路治疗Lauge-Hansen旋后外旋Ⅲ~Ⅳ度踝关节骨折的临床疗效比较  

Comparison of clinical efficacy between mippo minimally invasive approach and posterior lateral approach in the treatment of Lauge Hansen supinated external rotation Ⅲ~Ⅳ degree ankle joint fractures

作　　者：任冬[1] 李伟[1] 杨正刚[1] 刘忠鑫 黄楠 REN Dong;LI Wei;YANG Zheng-gang;LIU Zhong-xin;HANG Nan(Chengdu Sixth People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第六人民医院,四川成都610051

出　　处：《实用医院临床杂志》2024年第3期94-97,共4页Practical Journal of Clinical Medicine

基　　金：成都市卫生健康委员会科研基金资助项目(编号:2022381)。

摘　　要：目的对比mippo技术微创入路和后外侧入路治疗踝关Lauge-Hansen旋后外旋Ⅲ~Ⅳ度骨折的临床疗效。方法2019年1月至2022年1月我院收治的踝关节Lauge-Hansen旋后外旋Ⅲ~Ⅳ度患者60例,按照手术方法不同分为mippo技术微创入路组(A组)和后外侧入路组(B组)各30例,比较两组手术时间、透视次数、失血量、术后疼痛视觉模拟评分(VAS)、踝关节疼痛持续时间、并发症、踝关节功能、骨愈合等情况。结果两组随访时间14~24月[(22±3)月]。A组切口长度、出血量、住院时间、术后VAS评分、术后疼痛持续时间明显小于B组,术中透视次数、手术时间多于B组(P<0.05);术后3月A组患者骨折愈合优良率高于B组(P<0.05);两组患者术后6个月骨折均达骨性愈合且无畸形愈合;术后12个月两组踝关节功能优良率比较差异无统计学意义(P>0.05),但并发症率明显低于B组(P<0.05);两组均无切口感染、骨折畸形愈合、骨不连、内固定松脱等并发症发生。结论mippo技术对比后外侧入路治疗踝关节旋后外旋Ⅲ~Ⅳ度骨折均能较好恢复踝关节功能,但前者手术侵袭性更小、并发症发生率更低,疼痛持续时间更短,骨折愈合更快。Objective To compare the clinical efficacy between mippo technique minimally invasive approach and posterolateral approach in the treatment of Lauge Hansen supination external rotation Ⅲ~Ⅳ degree ankle joint fractures.Methods From January 2019 to January 2022,60 patients with Lauge Hansen supination Ⅲ to Ⅳ degree ankle joint in our hospital were collected.The patients were divided into a group A and a group B according to surgery methods,30 in each group.The group A was treated with mippo minimally invasive approach and the group B was treated with posterolateral approach.The surgical time,fluoroscopy frequency,blood loss,postoperative VAS score,duration of ankle pain,complications,ankle function and bone healing were compared between the two groups.Results The two groups were followed up for 14 to 24 months(22±3 months).The incision length,bleeding volume,hospital stay,postoperative pain VAS score,and postoperative pain duration in the group A were significantly smaller than those in the group B(P<0.05).The intraoperative fluoroscopy frequency and surgical time in the group A were higher than those in the group B(P<0.05).The excellent and good rate of fracture healing in the group A was higher than that in the group B after 3 months of surgery(P<0.05).All patients in both groups achieved bony union and no abnormal union after 6 months of surgery.After 12 months of surgery,there was no statistically significant difference in the excellent and good rates of ankle joint function between the two groups,but the incidence of complications in the group A was significantly lower than that in the group B(P<0.05).There were no complications such as incision infection,fracture malunion,bone nonunion or internal fixation loosening in both groups.Conclusions Compared with the posterior lateral approach,mippo technology can effectively restore ankle joint function in the treatment of ankle joint supination external rotation Ⅲ~Ⅳ degree fractures.Moreover,mippo technology is a less invasive surgery,and has lower in

关 键 词：MIPPO技术 经腓骨后外侧入路 踝关节旋后外旋型骨折 

分 类 号：R683.42[医药卫生—骨科学]